According to new research, levels of depression and anxiety in patients with severe rheumatoid arthritis (RA) are higher than previously reported. As such, a multi-center team led by researchers at the Arthritis Research UK Centre for Genetics and Genomics at the University of Manchester suggest that patients with a severe form of this condition waiting to go onto a biological therapy should be routinely screened for depression by their physician.

For the study, the research team carried out an observational study of 322 patients with severe RA who were waiting to go on a biologic therapy. The aim of the study was to investigate the impact of psychological factors upon each of the different parts of the current measure of disease called the DAS28, which is a score that takes into account the number of tender and swollen joints as well as the level of inflammation in the body.

The DAS28 also includes a subjective, patient-reported measure based on how well the patient is feeling. The research team found that subjective measures of response were more likely to be influenced by psychological factors, such as mood, according to a Science Daily news report.

Lis Cordingley, PhD, CPsychol, AFBPsS, says, “This may seem obvious but has not been reported before and is important because without treating the depression, the patient’s DAS28 score might not improve as much as it should on a biological drug, and doctors may assume the drug is ineffective.”

Professor Anne Barton, who led the research team, states, “This is the first study of its kind in patients with high levels of active disease, and suggests that routinely assessing a patient’s moods and beliefs — separate to their physical state — would be useful in guiding patient management.” Barton adds, “As rheumatologists we need to be aware that depression may occur more commonly in patients with severe rheumatoid arthritis than we had realized.”

Source: Science Daily